‘development’

Last night four Swansons sat in row 6 of a little commuter airplane on the way to visit family, all plugged in. Four people who love each other with four separate devices hardly communicating for the two hours or so that we sped through the air. At first glance it can look like an utter failure — you can hear the criticism ringing in your ears — this family must not be connected, or these working parents, pounding out emails and prepping presentations while their children watch videos and play apps, really must have their priorities off, right? Right.

Maybe.

On that flight I read a beautiful blog post from tenacious pediatric researcher Dr Jenny Radesky that questions the new world in which children are being reared. The one where their parents are plugged-in, distracted, perhaps less attentive and less available while raising infants and young toddlers. It’s the same world today, where preteen digital natives may be connecting more by text than by talking. She cites data that found, “if you take away preteens’ mobile devices and make them hang out with their peers in the country for one week, they get better at reading other people’s facial expressions.” Perhaps these children and teens are swapping thumb skills for interpersonal ones. Radesky is the researcher behind the observations out last year evaluating parents’ use of mobile phones at dinner that alarmingly demonstrated children’s near need to act out to get their parents’ attention. Are our parent-child connections forever changed because of the profound brilliance that digital devices have in capturing our attention? Radesky brings up the zone of proximal development (I’d not previously heard of it) and its profound value. She says,

In order to effectively teach children how to regulate their behavior, we need to interact with them in what psychologist Lev Vygotsky termed the child’s “Zone of Proximal Development (ZPD).” This means knowing their cognitive and emotional sweet spots: what they can do on their own, what they can’t do, and what they can do and learn with an adult’s help. You can’t fit the puzzle pieces in yet? Let me guide your hand a little bit until you figure it out by yourself. You can’t calm down when you’re frustrated yet. Let me help you identify what emotion you’re feeling and then show you some options for calming your body down. And I’ll slowly take my support away until you can do this skill on your own.

Oh yes, we certainly do need to be in this space and be available, eyes connected, body engaged, actively listening to the loves of our life (children). In championing this reality we can easily finger-wag that how things used to be (without smart phones and wild virtual connection to data and community) is better. Slow down, unplug, unwind, and CHECK BACK IN, right? Common Sense Media even has a new PSA campaign, that I happen to love, tagged #realtime guiding us back to life with a series of delicious, tight videos reminding us how we mess up. Read full post »

The boys and I read two extra books last night — we almost skipped it altogether as it was late and we were beat from a long day and yada, yada, yada…you know the drill. But reviewing this data changed me, yet again. I knew some of the value of reading to young children before I had kids because of my experiences being a teacher and my training in pediatrics but the refreshers provided this week only compound my interest in screaming the value of reading from the rooftops.

It’s NEVER too early to start reading to your baby. Reading aloud before bed is always the right thing to do.

This week The Clinton Foundation with Too Small To Fail, The American Academy of Pediatrics, Reach Out And Read, and Scholastic got serious about ensuring our country takes reading seriously right out of the gate. For the first time ever the groups have come together to proclaim that parents should start reading to children “as early as you can” after birth. The new policy and partnership emphasizes the need for early reading to all infants and children while also emphasizing the necessity that all pediatricians promote this healthy habit at birth and through all preschool doctor visits. Profound health disparities currently exist for US children and book time. I suspect the numbers will surprise you.

It’s a no-brainer to most parents I talk with that reading books enhances development, literacy, and school readiness. What may surprise you is that reading has also been found to enhance the relationship between a child and parent. Reading books (or even the newspaper) to your infant from day one can have profound effects on how they live, how they talk, and how they learn — the impact extends well into adulthood. From the very beginning, though, some children are missing out. Children from low-income families hear fewer words in early childhood and know fewer words by 3 years of age creating the “word gap” early in their lives. The more words a child hears during early, critical times for language development, the more they’ll know. And although reading books can be a great resource to introduce an expansive, enriched vocabulary, less than 1/2 of children are read aloud to in this country every day.

All families face issues of limited time, limited parental understanding of the key role of reading aloud, and competition for the child’s interest and attention from other sources of entertainment ~ The American Academy of Pediatrics Council on Communications And Media ( 2011)

A new policy statement from The American Academy of Pediatrics finds that many women, including up to 1/3 of pregnant women, may have low levels of iodine putting them at risk for iodine deficiency. The reason for the deficiency is the changing food source. Over the last 20-30 years our major source of salt has shifted away from table salt (supplemented with iodine) to salt from processed foods, sea salt or gourmet salts that have no supplemental iodine. This is especially important for breastfeeding and pregnant women as iodine is essential for thyroid function that supports fetal and newborn brain development.

This policy statement was news to me. I had no idea that the salt used to make most processed foods lacked iodine, that the majority of prenatal vitamins didn’t provide iodine, and the number of women who may have a deficiency. I’m not alone; when I polled my Mama Doc Facebook community most moms & many doctors also commented this was a newsflash. Here’s more:

Iodine Deficiencies– Shifting Sources Salt

WHY ARE WE DEFICIENT? Most processed foods made are with salt that is not iodized. Since we get most of our salt from those foods we’re taking in less iodine than we used to.

TABLE SALT INTAKE: Table salt is iodized, many gourmet salts are not. Consider ensuring that when cooking in your home (ie putting salt in the pasta water or salting the veggies) you use iodized table salt so your intake of iodine goes back up. REMEMBER: this doesn’t mean you should eat MORE salt, just swap in the table salt for the fancy salts when you can.

WHY DO WE NEED IODINE? We need iodine for thyroid hormone synthesis as thyroid is essential in brain development and metabolism. The policy reminds us that even mild iodine deficincy can affect fetal and early childhood neurocognitive development stating, “adequate thyroid hormone production is critical in pregnant women and neonates because thyroid hormone is required for brain development in children.” The recommendations from AAP spelled out:

We had a marvelous Father’s Day weekend. On Saturday we started a Dad-coached soccer team with some friends which was surprisingly successful. And then on Sunday, we completed our first-ever family bike ride on the Burke-Gillman trail. Everyone had two wheels of their own, including Grandma. Although O ended up in the ditch at one point after steering off-course, it was an injury-free ride and we proclaimed it a success. I think we all felt really grown up. We gave my husband a mixture of homemade gifts (paintings) and then a trite, expected one (a necktie). We played ball in the yard, pulled weeds from the grass, and Jonathan got a bit of time to himself for a run. When we went out for Italian food and ordered Shirley Temples we formally celebrated the fortune of having a father parenting so actively in our lives. The boys began the day with exclamations and closed it with a final, “Happy Father’s Day” after the lights went out. It was then that I realized it’s prime time for this holiday in our home.

I get that Father’s Day isn’t this Hallmark in everyone’s home and I certainly understand it won’t always be like this. These manufactured holidays bring up thoughts of the tension and distance many of us feel from our own fathers. I also think about my friends and patients who have lost their fathers and those children who are separated from their fathers due to work, military commitments, or unique family circumstances. Last week one of my colleagues pointed out that children had eras in their lives where Father’s Day was on the map; young children adore and celebrate but then retreat as we’d expect during the late school-age years. “They tend to check back in during young adulthood,” he said.

And it got me thinking: is there a way to keep the intimacy of preschool-parenthood alive? Read full post »

Separation anxiety varies WIDELY between children. Some babies become hysterical when Mom is out of sight for a very short time, while other children seem to demonstrate ongoing anxiety at separations during infancy, toddlerhood, and preschool. I’ve got one of each in my home. The trick for surviving separation anxiety demands preparation, brisk transitions, and the evolution of time. I would suggest we parents suffer as much as our children do when we leave. Even though we are often reminded that our children stop crying within minutes of our leave-taking, how many of you have felt like you’re “doing it all wrong” when your child clings to your legs, sobs for you to stay, and mourns the parting? As a working mom, separation anxiety creates questions for me. Although it is an entirely normal behavior and a beautiful sign of a meaningful attachment, separation anxiety can be exquisitely unsettling for us all. Here are facts about separation anxiety and 6 tips to improve the transitions I’ve learned the hard way (I’ve made about every mistake). Read full post »

18 month-olds are extremely determined, constantly challenging, tenacious, adorable, witty, and ever-aware. By 18 months, most babies have really figured out how to get and hold a parent’s attention! As they explore their widening world, an 18 month-old’s curiosity leads while their judgment lags well behind. Providing your child with a safe and consistent environment is paramount. Development in all areas (gross motor, personal and social, fine motor, etc) is highly variable but the video reviews typical milestones your baby’s clinician will review around 18 months of age.

What Should My Baby Do At 18 Months?

In general by 18 months, your toddler will be very curious. They will be demanding. They will be communicating wants and needs through words, motions, and imitations. They will be pointing out objects in the sky. They will be calling you by a name just as they run the opposite way…

“Mr No” — I found this extensive list of milestones and observations both very entertaining and educational

What Parents Can Do For 18 Month-Olds:

Give your 18 month-old their space. As they crave more and more autonomy, provide them times for a bit of freedom.

Let your child mimic you. Give them toys or safe objects you use in the house so that they can pretend to be an adult.

Let them help. Start finding daily or weekly “chores” for your 18 month-old (ie bringing napkins to the table or moving stuffed animals to a bin). They’ll love their role!

Offer puzzles, matching, and sorting games.

Read to your 18 month-old every single day. Point out objects in the book. Ask your toddler to tell you the names of animals or toys in the book. Get them involved. And get ready to read the same book over and over and over again!

Keep rules to a minimum. Rather, define “right” from “wrong” for your child and remember to praise your 18 month-old for doing things right. Catch them when they are being good!

A new study, along with an incredible editorial, was published today in Pediatrics about the effects of watching fast-paced cartoons on the attention and working memory of 4 year-olds. It’s basically a Spongebob versus Crayola versus Caillou show-down. At least it feels that way in the media summaries today. And thus, it’s bound to hit the front pages of every parent’s windshield. First and foremost, it’s a genius study for getting the word out and attracting media attention–media love to talk about media. Especially when it comes to the effects on children; all forms of media are looking for a viable option for longevity. There is just so much competition now.

Also, the study is interesting. Plain and simple, I couldn’t wait to read it. We watch Caillou around here and my husband and I like to dissect and ridicule it (in private)–everything from the outfits to the color scheme to the lessons. As a parent, it’s kind of painful to watch–its just so utterly wholesome and slow. On the flip side because of this goodness in the the content and pace, we feel less “guilty” letting the boys watch it. The result has been a win-win: the boys looooooove it–I mean, love it–and we pat ourselves on the back for the choice. Good media is far better than bad media, we think. Fortunately, the data backs up our instinct. And this helps with our mommy-daddy-guilt. We’re a really low media viewing house, but not the lowest. We have friends whose children don’t see a screen for months at a time. Read full post »

I found my sons’ first birthdays very emotional. Magical, even. Looking back provided great perspective on how much can happen in 1 year of time. What our children accomplish in the first 12 months is simply astonishing.

Expected milestones at 1 year of age:

Maaaaaaajor milestone in our house today. O filled up his first reward chart for potting training. Even bigger, last night just before he went to bed, O and I discussed that he only had two spaces left on the chart. Once filled, he gets a special trip to the toy store. Although seemingly unclear about the rules and benefits of the chart last night, he told me he would wait until morning to pee.

Thing is, he did.

He awoke with a dry diaper. We felt like lottery winners! O went to the bathroom, peed in the toilet, and then came to find me this morning. His 4 1/2 year old brother did the reporting:

“O peed much more than we thought he could this morning, Mommy.”

I was astonished. I went to the toilet to see the evidence. Dark yellow bowl of pee. Immense pride….I think my heart pushed out a double-beat. Read full post »

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Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.